Gendreau et al reported a nomogram for predicting the risk of poor outcome for a patient with systemic vasculitis with gastrointestinal tract involvement. This can help to identify a patient who may benefit from more aggressive management. The authors are from multiple institutions in France and members of the French Vasculitis Study Group.
Patient selection: systemic vasculitis with gastrointestinal involvement
Poor Outcome: ICU admission, surgery for worsening disease, or death within 6 months
Parameters:
(1) type of vasculitis
(2) ECOG performance status
(3) use of morphine
(4) ileus
(5) guarding
(6) melena
(7) WBC count from 0 to 60 * 10^9/L
(8) hemoglobin in g/dL from 4 to 22
(9) CRP in mg/L from 0 to 450
points for hemoglobin =
= 122.22 - (5.56 * (hemoglobin))
points for WBC count =
= 1.193 * (WBC)
points for CRP =
= (4.831 * LN(CRP)) - 0.1831
|
Parameter
|
Finding
|
Points
|
|
type of vasculitis
|
IgAV
|
0
|
|
|
PAN
|
28.1
|
|
|
other
|
18.9
|
|
ECOG performance
|
0
|
0
|
|
|
1
|
8.36
|
|
|
2
|
16.72
|
|
|
3
|
25.08
|
|
|
4
|
33.45
|
|
morphine
|
no
|
0
|
|
|
yes
|
22.7
|
|
ileus
|
no
|
0
|
|
|
yes
|
28.1
|
|
guarding
|
no
|
0
|
|
|
yes
|
20.7
|
|
melena
|
no
|
0
|
|
|
yes
|
25.1
|
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score> 359.1
value of X =
= (0.04 * (score)) - 5.847
probability of poor outcome =
= 1 / (1 + EXP((-10 * X))
Performance:
• The area under the ROC curve is 0.85.
